NYAPRS Note: The following approach goes one step beyond the Crisis Intervention Team approach that trains police officers to better respond to individuals in mental health crises, sometimes accompanied by community mental health professionals: those professionals act as first responders without the police.

When Mental-Health Experts, Not Police, Are the First Responders

Program In Eugene, Ore., is Viewed as a Model for Reducing Risk of Violence

By Zusha Elinson The Wall Street Journal November 24, 2018

EUGENE, Ore.—They are the kind of calls that roll into police departments with growing regularity: a man in mental crisis; a woman hanging out near a dumpster at an upscale apartment complex; a homeless woman in distress.

In most American cities, it is police officers who respond to such calls, an approach law-enforcement experts say increases the risk of a violent encounter because they aren’t always adequately trained to deal with the mentally ill. At least one in every four people killed by police has a serious mental illness, according to the Treatment Advocacy Center, a nonprofit based in Arlington, Va.

But in Eugene, Oregon’s third-largest city, when police receive such calls, they aren’t usually the ones who respond. Here, the first responders are typically pairs of hoodie-wearing crisis workers and medics driving white vans stocked with medical supplies, blankets and water.

They work for a nonprofit program called Cahoots—which stands for Crisis Assistance Helping Out On The Street—and they spent a recent November night calming tense situations, offering medical aid, and pointing people toward shelters. Launched by social activists in 1989, Cahoots handled 17% of the 96,115 calls for service made to Eugene police last year.

“When I’m talking to a more liberal group of people, I’ll make the argument it’s the compassionate thing to do, it’s the humane thing to do,” said Manning Walker, a 35-year-old Cahoots medic and crisis worker. “When I’m talking to a conservative group, I’ll make the argument that it’s the fiscally conservative thing to do because it’s cheaper for us to do this than for the police and firefighters.”

In 2017, police officers spent 21% of their time responding to or transporting people with mental illness, according to preliminary data from a survey of 355 U.S. law enforcement agencies by the Treatment Advocacy Center.

More police departments across the country are training their officers in techniques to deal with the mentally ill. Los Angeles, Houston and Salt Lake City pair officers with mental-health workers with police officers to respond to certain calls. Still, the Center found that in 45% of the agencies polled the majority of officers haven’t received crisis-intervention training.

Last month, a 36-year-old man died after being repeatedly tased by San Mateo County Sheriff’s deputies responding to calls about a person walking in traffic. Chinedu Okobi, who struggled with mental-health issues, was unarmed. The sheriff’s office said he assaulted an officer, but his sister, a Facebook Inc. executive, said video of the incident shows he wasn’t a threat.

“They started shouting at him, they chased him and they tased him,” said Ebele Okobi, Facebook’s head of public policy for Africa. “None of that is how you interact with someone in crisis.”

The district attorney is investigating the incident.

Public anger over police killings has pushed law-enforcement leaders in California to discuss how to replicate Eugene’s program in their state, said Brian Marvel, president of the Peace Officers Research Association of California, which represents more than 70,000 public-safety union members.

“If someone is having a mental issue then let’s send the pros who actually deal with this,” said Mr. Marvel.

In Olympia, Wash., police are setting up an $800,000-a-year program inspired by Cahoots as the city grapples with a growing population of homeless people who suffer from mental illness, said Lt. Paul Lower.

The program in Eugene is unique because Cahoots is wired into the 911 system and responds to most calls without police. The name Cahoots was intended to be a humorous nod to the fact that they are working closely with police. Cahoots now has 39 employees and costs the city around $800,000 a year plus its vehicles, a fraction of the police department’s $58 million annual budget. They are also paid to handle calls for a neighboring Springfield.

“It allows police officers to…deal with crime, but it also allows us to offer a different service that is really needed,” said Lt. Ron Tinseth of the Eugene Police Department.

In contrast to police officers who typically seek to project authority at all times, Cahoots employees dress in black sweatshirts, listen to their police radios via earbuds, and speak in calm tones with inviting body language.

“I’ve learned ways to make myself smaller,” said Mr. Walker, a bearded, 6’ 2” former firefighter.

Gary Marshall, a 64-year-old who previously lived on the streets of Eugene, said the police approach was “name, serial number and up against the van.” In contrast, when he was having one of his frequent panic attacks, Cahoots counselors would bring the him inside and talk him down, he said.

When Mr. Walker and his partner Amy May, a crisis counselor, approached a man lying in the middle of the sidewalk on a busy street, they sat down on the cold cement at eye level and asked what he needed. He was thirsty and cold, so they gave him water and a tarp. They suggested places to sleep and the man moved along.

That same night, they arrived at the home of a teen who had been punching her mother. The air was thick with tension. They listened to the girl’s story—adults were always trying to control her—as she stood above them on the porch steps. They talked with the mother. After an hour and a half, they brokered a peace treaty devised by the warring parties.

“We believe that people are the best experts in their own lives,” said Ms. May.